As top cancer centers affiliate brands with smaller hospitals, safety and quality don't always match, study finds

Top-ranked cancer hospitals such as Mayo Clinic and Cleveland Clinic are increasingly sharing their brands with other hospitals through affiliations.

But the likelihood of surviving complex cancer surgery appears to be greater for patients who had the procedure at the top-ranked hospital rather than at their affiliated hospitals, according to a study published in the JAMA Network Open.

Researchers from the Yale School of Medicine looked at mortality rates of nearly 30,000 Medicare beneficiaries after complex cancer surgery at hospitals participating in networks with top-ranked cancer hospitals between 2013 and 2016.

They found about 50% of those patients had complex cancer surgery at a top-ranked hospital and about 41% had surgery at an affiliate hospital. Overall, they found that surgery performed at one of the affiliated hospitals was associated with a higher 90-day mortality. 

RELATED: Mayo Clinic expands with health system affiliation

"This is not entirely surprising, as affiliated hospitals are generally smaller, less likely to be teaching hospitals, and perform complex surgical procedures with less frequency (lower volume) when compared with top-ranked hospitals," researchers wrote in their study While top-ranked cancer hospitals are able to share the trusted brand with an affiliate, it doesn't necessarily mean patients can expect the same quality or safety outcomes from that brand at an affiliate.

The authors suggested mortality might be reduced if the most dangerous of the complex procedures were steered toward the safest hospitals in each network. They also suggested the leading cancer hospitals have some responsibility for leveraging relationships with affiliated hospitals to ensure safety and quality is optimized.